Guest Column

Equity, not equality, is the only way to effectively address health disparities.

Dwight Tillery of the Center for Closing the Health Gap

In Cincinnati, as in other cities around the
United States, the top causes of death are heart disease, stroke,
cancer, diabetes and chronic lower respiratory (lung) disease. Death
rates in Cincinnati tend to be higher than Ohio, overall, and much
higher when compared to the rest of the United States.

While these data are startling, what is even more
surprising is how health can differ even within Cincinnati. Data from
2001-2009, released by the Cincinnati Health Department, highlighted
differences in average life expectancy in Cincinnati. The average life
expectancy for the city is 76.7 years; if you live in Mt.
Lookout/Columbia Tusculum, average life expectancy is 87.8 years. If you
live in South Fairmount, average life expectancy is only 66.4 years.
This means that, depending on where you live in Cincinnati, your life
expectancy could vary by 20 years or more! In fact, 29 of the 47
neighborhoods in Cincinnati have a life expectancy that is less than the
average for the entire city.

How does where one lives impact health? Availability
of health-related resources and opportunities to engage in healthy
behaviors, like eating fresh fruits, are key to improved health.
Communities lacking resources have poorer health and more disease than
communities with more resources. In addition, low or under employment,
high poverty and high stress can contribute to crime rates and unhealthy
coping behaviors like alcoholism and drug use.

Health disparities is defined as “a particular type
of health difference that is closely linked with social or economic
disadvantage…adversely affect[ing] groups of people who have
systematically experienced greater social and/or economic obstacles to
health and/or a clean environment based on [personal characteristics].”
Historically, systematic discrimination has been related to outward
personal characteristics, primarily race and ethnicity, and overt and
institutionalized racism has systematically limited opportunities for
non-white citizens, including opportunities for optimal health.

Since 2004, The Center for Closing the Health Gap
(The Health Gap) has been working toward a mission of eliminating racial
and ethnic health disparities in Greater Cincinnati through the use of
our grassroots model where we engage, empower and advocate creating a
culture of health.

We do our work in and with communities. We work
alongside community members to understand the factors that make it
difficult to maintain healthy behaviors given the available resources in
the community. Community members also work with us to identify
effective strategies that can improve factors that influence health,
like income and socioeconomic status and living conditions.

Some of our signature programs have provided
opportunities for mass access to health screenings through the annual
Health Expo, educational classes such as the Mt. Auburn Do Right!
program, and environmental improvements through our healthy corner store
initiative.

The Health Gap is fighting not for equality, but for
equity in health. Health equity means people in equal need deserve
equal access to health care. Dr. Martin Luther King Jr. once said “Of
all the forms of inequality, injustice in health care is the most
shocking and inhumane.” The Center will continue to strive for health
equity by directly addressing factors, like racism, that have
systematically restricted access to optimal health. It may require
allowing what could be perceived as special treatment to allow those
with the fewest resources opportunities to access health care and
resources so that, in the end, we can all benefit. n

Dwight Tillery grew up in Cincinnati’s West End has
held a number of distinguished professional positions throughout his
career. In 1991, he became the first African American popularly elected
mayor of Cincinnati. He also served as a member of city council; where
he sponsored many pieces of legislation that benefited the poor and
minorities. He is founder, president and CEO of The Center for Closing
the Health Gap in Greater Cincinnati whose mission is “to lead the
efforts in eliminating racial and ethnic health disparities in Greater
Cincinnati through Advocacy, Education, and Community Outreach.”